A patient with type 2 DM was admitted to the hospital with a…

A patient with type 2 DM was admitted to the hospital with altered consciousness and the following lab values: serum glucose 500mg/dL (high) with normal pH.  She states that she has been sick with the “flu” for a week.  The diagnosis is hyperosmolar hyperglycemia nonketotic syndrome (HHNKS).  The NP knows that this is characterized by: